Conspiracy theories used to be seen as bizarre expressions of harmless eccentrics. Not any more. Gone are the days of outlandish theories about Roswell’s UFOs, the “hoax” moon landings or grassy knolls. Instead, today’s iterations have morphed into political weapons. Turbocharged by social media, they spread with astonishing speed, using death threats as currency.

Together with their first cousins, fake news, they are challenging society’s trust in facts. At its most toxic, this contagion poses a profound threat to democracy by damaging its bedrock: a shared commitment to truth.

Their growing reach and scale is astonishing. A University of Chicago study estimated in 2014 that half of the American public consistently endorses at least one conspiracy theory. When they repeated the survey last November, the proportion had risen to 61%. The startling finding was echoed by a recent study from the University of Cambridge that found 60% of Britons are wedded to a false narrative.

The trend began on obscure online forums such as the alt-right playground 4chan. Soon, media entrepreneurs realized there was money to be made – most notoriously Alex Jones, whose site Infowars feeds its millions of readers a potent diet of lurid lies (9/11 was a government hit job; the feds manipulate the weather.)

Now the conspiracy theorist-in-chief sits in the White House. Donald Trump cut his political teeth on the “birther” lie that Barack Obama was born in Kenya, and went on to embrace climate change denial, rampant voter fraud and the discredited belief that childhood vaccines may cause autism.

Amid this explosive growth, one aspect has been underappreciated: the human cost. What is the toll paid by those caught up in these falsehoods? And how are they fighting back?

The Guardian talked to five people who can speak from bitter personal experience. We begin in a town we will not identify in Massachusetts where a young man, who tells his story here for the first time, was asleep in his bed.

Valentine’s Day 2018 was Marcel Fontaine’s day off. They slept late into the afternoon, having worked a double shift the day before. When they woke up, a wave of happiness washed over them – they were in a relationship, had a job they loved at a local concert venue. Their life was good.

By the time they roused themselves, the deadliest high school shooting in US history was already over. A 19-year-old with an AR-15 semi-automatic rifle had entered the Marjory Stoneman Douglas high school in Parkland, Florida, and opened fire. Seventeen had been killed, though Fontaine, who has no cable TV or radio, was oblivious to the tragedy.

Then they received a text from a friend. A photo of Fontaine was flying around the internet and they were being accused of carrying out the terrible Florida shooting.

Their immediate response was bewilderment. What shooting? Where? Fontaine was in Massachusetts, 1,500 miles away. It would take a four-hour flight to reach the school. They’d only visited Florida once when they were a little boy to see Mickey Mouse.

Fontaine, 25, describes themselves on Twitter as a “non-binary gay queer autistic commie that loves horror movies and metal!” They were diagnosed as being on the autism spectrum as a child and for years has struggled with anxiety and a debilitating stammer. At moments of heightened stress, they flap their hands like a bird.

In short, Fontaine is a vulnerable leftwing individual who would not harm a flea, which apparently makes them perfect fodder for the sadistic mockery of 4chan, the anonymous message board that hosts alt-right activists and other extremists.

A few days before the Parkland shooting, a photo of Fontaine wearing a T-shirt of Marx, Lenin, Mao and other communist luminaries dressed in party hats had been grabbed from his Instagram feed and posted by an anonymous user on 4chan, where they were promptly derided as a “lefty dimwit”. The T-shirt, Fontaine protests, was a joke, a pun on Communist party.

In the conspiratorial bubble of 4chan, it was but a small step from ridiculing Fontaine to casting them as the Parkland shooter. Within two hours of the massacre, the image had been reposted on the bulletin board, now saying: “Florida Shooter Was A Commie!”

Marcel Fontaine was horrified to discover that they were accused of being the Parkland gunman. It upended their life. Photograph: Ali Smith/The Guardian

From there, Alex Jones’s conspiracy theory site, Infowars, leapt into the fray. Its “reporter” lifted Fontaine’s photo directly from 4chan and, without any attempt at verification, ran with it on the front page. “Shooter is a commie. Alleged photo of the suspect shows communist garb,” the outlet screamed. The false rumor quickly spread from Miami to Beijing.

Fontaine was horrified. “I knew a lot about the Alex Jones fanbase – that they were radical extremists who believe every word he says, and that a lot of them hold firearms. I knew my life was at risk.”

The first death threats landed via Facebook messenger by nightfall: “I hope someone throws you out of a rotary aircraft, you commie!” Another made a direct reference to the concert venue that employed them. “They knew where I worked, what I did. It just got me so afraid.”

Death threats and autism spectrum conditions make poor bedfellows, and exacerbated Fontaine’s condition, ramping up their anxiety, insomnia and social isolation.

“I wasn’t able to function, to cook, do basic tasks. I went days without taking a shower. I didn’t want to go out, I just wanted to be with myself.” Soon, they started having frequent panic attacks.

Over the past six months, Fontaine has slowly pulled themselves back together. They are in therapy to combat the bouts of panic and sleeplessness that still trouble them. But they have become less trusting of people and freezes whenever they see someone dressed in camouflage or wearing a Make America Great Again hat. Do they read Infowars? Fontaine wonders. “I get very nervous because they might recognize me and want to actually pull something out on me. Or like beat me to a pulp.”

As the anniversary of the shooting approaches, they find it hard to understand why they were singled out. “It makes me sad. This event got me to a point where I just can’t be myself again.”

Lenny Pozner, 51, is preparing to pack his bags, again. A few weeks ago, “hoaxers” – as he calls conspiracy theorists – reproduced a map of his Florida neighborhood with a dropped pin marking the precise location of his apartment. It will be the eighth time in five years he will have been forced to move home as he strives to keep one step ahead of the fanatics who relentlessly hound him.

Pozner’s crime, in the eyes of conspiracy theorists, is being the father of one of the 20 children who were gunned down in the mass shooting in Newtown, Connecticut, in December 2012. Noah was the youngest of all victims. He had just turned six.

Within months, conspiracy theorists, egged on by Alex Jones and Infowars, went to work. They generated thousands of web posts and a 426-page book called “Nobody Died at Sandy Hook”.

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Their thesis: the shooting at the elementary school never happened. The 20 kids who died were “crisis actors”. The tragedy was a con. Noah had never even existed, he was a construct of Photoshop.

Within a year, it had reached such a pitch that Pozner knew he had to do something. “I agonized about the situation for several weeks. But ultimately I felt I owed it to my son to protect his memory.” He posted on his Google+ page his son’s birth and death certificates and kindergarten report card.

“I was extremely naive. I believed that people were simply misinformed and that if I released proof that my child had existed, thrived, loved and was loved, and was ultimately murdered, they would understand our grief, stop harassing us, and more importantly, stop defacing photos of Noah and defaming him online.”

Instead, he watched his deceased son buried a second time, under hundreds of pages of hateful web content. “I don’t think there’s any one word that fits the horror of it,” Pozner says. “It’s a phenomenon of the age which we’re in, modern day witch-hunts. It’s a form of mass delusion.”

Lenny Pozner has been fighting to prove his son’s existence and has moved house multiple times to escape death threats. Photograph: Ali Smith/The Guardian

Pozner is extraordinarily controlled. His voice is flat and preternaturally calm, as though all emotion has been pummeled out of him. His apartment has the same pared-down, antiseptic quality. “I’ve gotten good at moving, I’ve adapted to it,” he says.

He left Newtown for Florida in 2013 with Noah’s mother, his now former wife Veronique De La Rosa, and their two daughters in the hope of rebuilding their lives. (He asked the Guardian not to identify the town he now lives in.) He has deliveries sent to a separate address and has rented multiple postal boxes as decoys.

The most serious of death threats came from Lucy Richards, a Florida resident who was so fervent in her belief that the Sandy Hook massacre was fake that she left messages on Pozner’s cellphone saying: “You’re going to die. Death is coming to you real soon, and there’s nothing you can do about it.” In June 2017, Richards was sentenced to five months in prison, followed by a further five months under house arrest.

Pozner sees this outpouring of hatred as a product of digital technology running ahead of society’s ability to contain it. “Social media hasn’t matured. We lack a segment of law enforcement specializing in it. There really is no one to help.”

But he reserves his staunchest criticism for Alex Jones, who he blames for amplifying conspiracies in the pursuit of profit. In a lawsuit suing Jones for defamation for more than $1m, lawyers for Pozner and De La Rosa chronicle how Infowars baited them over many years: the shooting was “staged”, a “giant hoax”. The school was an elaborate film set. It was all a “soap opera”.

But in targeting Pozner, Jones picked on the wrong guy. Since 2014 Pozner has made it his life’s work to confront the conspiracy theorists. Through his organization the Honr Network, Pozner has systematically challenged those who he believes cross that line, forcing moderators to delete posts. In 2018 alone, he reported 2,568 videos to YouTube and had 1,555 of those expunged.

Pozner’s lawsuit against Jones, which mirrors a similar legal case brought by Fontaine, is making its way through a federal court in Austin, Texas. Earlier this month they received a legal boost when the judge granted them access to Jones’s financial and marketing documents under discovery.

Jones denies defaming anyone, though he has so far failed in having the suits dismissed on free speech grounds.

Regarding the free speech argument, Pozner says: “You have the right to express yourself and your opinions, no matter how offensive they may be, until your chosen form of expression impedes my rights to be free from defamation and harassment.”

What shocks Pozner most, he says, was how alone he was when he began this fight. “I was the only one standing up to the hoaxers, and other than the loss of my son that was my biggest disappointment at the time.”

At least he has brought his son’s memory back to life. If you search Noah Pozner on Google you will find hundreds of articles about the boy’s life and death, and virtually none of the bile from those who questioned his existence.

By Pozner’s reckoning, one in five people around the world are suggestible to conspiracy theories, and their obsessions are amplified by the crude logic of digital algorithms. “There is just no more truth, there is just what’s trending on Twitter,” he says. “Used to be, you had to burn books to keep people from finding out the truth, now you just have to push it to page 20 of a Google search.”

Dr Paul Offit strode into a dispute over the safety of children’s vaccines in 1998. Twenty years later, he is still embroiled in it. His latest death threat arrived only about a month ago, when someone wrote on a forum frequented by vaccine skeptics that Offit was “dead already so they might as well assassinate him”.

Offit’s worldview, as a pediatrician at the Children’s hospital of Philadelphia who has himself created a vaccine against rotavirus, had always revolved around the scientific method and evidence-based reality. “The assumption was that if you publish good papers in good journals, truth emerges and people abandon ill-founded beliefs. Didn’t work that way.”

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In 1998, the since-discredited British gastroenterologist Andrew Wakefield published a paper in medical journal the Lancet linking the MMR vaccine (against measles, mumps and rubella) to autism. Wakefield went on to advise parents to avoid MMR immunization for their children, spreading pandemonium across Europe and the US. In 2000, Offit decided to act, shocked that nobody was standing up for science. He set up the Vaccine Education Center to give the public a basic appreciation of vaccines which globally prevent up to 3m deaths each year.

The backlash came almost immediately. It began with a flurry of emails calling him Satan, a Nazi. “It was devastating. It hurt, it always hurt, it still hurts. I never got so thick-skinned that when people assume my motives are evil it doesn’t hurt me.”

He was stalked by a man who followed him from from one speaking engagement to the next. Protesters appeared outside medical meetings bearing placards with Offit’s face above the word “TERRORIST”.

When Offit began speaking out against those who claimed, falsely, that vaccines caused autism, his home address was circulated and he received death threats. Photograph: Ali Smith/The Guardian

A voicemail was left for him at home. The man mentioned he had young children the same age as Offit’s. “We all want what’s best for our children, I’m sure you want what’s best for your children,” the man said, before going on to name Offit’s kids as well as the school they attended.

It was the one time that Offit considered dropping it all. That night, he talked to his wife, Bonnie, and offered to quit standing up for vaccines. “If Bonnie had said stop to me that night, I would have stopped.” Bonnie told him to hang in there. You’re doing the right thing, she said, for science, for children. You mustn’t let them shut you up.

Offit, 67, is hanging in there, sustained by two powerful motivations. The first is anger: although at least 17 major studies have found that MMR does not cause autism, conspiracy theorists continue to propound the falsehood. Offit is angry in particular at what he calls the “small group of professionals who do this as a living, the media-savvy, politically connected, lawyer-backed group” of anti-vaxxers who have become all the more vocal by using the internet as an organizing tool.

“I think they’re evil, to be quite frank. I think they hurt children, they put children in harm’s way and to me they have to be defeated.”

His second motivation: children. As the Guardian reported last month, anti-vaccine movements spurred on by rightwing populism are on the rise across Europe and immunization rates are plummeting as a result. The World Health Organization has included such movements – which it called “vaccine hesitancy” – among its top 10 global health threats for 2019.

The result of this surge in conspiracy theories around vaccines is that measles outbreaks are at a 20-year high. In 2018 there were more than 60,000 European cases with 72 deaths, twice the number from the year before.

Offit has seen at first hand what that means. One of the cases that haunts him is that of a mother who decided not to vaccinate her infant son against influenza, having read some fallacious material about the treatment.

The little boy was brought in to the hospital and went through a progression of increasingly invasive care as his body was ravaged with flu. First the child was given an oxygen face mask, then put in a ventilator, then an oscillator and heart-lung machine, until finally he died. “The mother watched her child die in slow motion, like falling off a cliff slowly. It was very hard.”

After the boy’s death, Offit asked the mother if she would be willing to talk to other parents wrestling with the decision to vaccinate as a way of preventing further tragedy. She politely declined. “She said to me she still thinks she made the right choice – the vaccine would have been more harmful.”

As a developer of video games, Brianna Wu is well placed to judge the stakes involved when someone becomes caught up in the real-world fantasy that is a conspiracy theory. To her trained eye, the chances of prevailing within the maelstrom are passingly low.

“If you address the conspiracy theory head-on, you just amplify the message you are trying to disprove. If you ignore it you just get screamed at and harassed until your career is over. It’s a no-win scenario,” she says.

Wu, 41, speaks from brutal experience. “I will never forget the day it happened,” she says, recalling when she tweeted a collage of comments lampooning male conspiracy theorists in her industry. “My Twitter caught on fire with all kinds of threats and nasty comments. I knew I had a choice to make: I could sit down and say nothing, or I could take a stand.”

She did take a stand, and by doing so, propelled herself into Gamergate, the misogynistic conspiracy theory that ran riot through 4chan, its sister imageboard 8chan, Reddit, Twitter and other social media platforms.

The blow-up began in 2014 when fellow video game developer Zoe Quinn became the target of hundreds of anonymous male trolls propagating the false claim that she had sought to advance her career by having an affair with a video game journalist. The conflagration spread like wildfire, engulfing several other women in and around the gaming world. The bedlam could not have come at a worse juncture for Wu, erupting just weeks after she had launched her first video game, Revolution 60.

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Wu believes that women are targeted by conspiracy theorists more frequently than men, and yet they’re rarely heard. “The cost of speaking out is so high for women, I understand why most decide not to. I’ve heard hundreds of times over the last few years women with children saying ‘I am afraid to speak up because I don’t want my children to be targeted’. That is an utterly rational position – many women are correctly scared to talk.”

Wu was scared, too. Her frivolous internet meme ridiculing the male trolls of Gamergate triggered an assault that continues to this day. At its peak, a woman turned up at her alma mater, the University of Mississippi, impersonating her in an attempt to acquire her college records. Someone else surreptitiously took photos of her as she went about her daily business. Wu was unaware of it until she received anonymous texts with pictures of her in coffee shops, restaurants, at the movies.

Brianna Wu became caught up in the conspiracy theory that falsely claimed women were getting ahead in the game industry by having sexual relationships with journalists. Photograph: Ali Smith/The Guardian

An accurate floor plan of her house was assembled and published online, along with her address and pictures of her car and license plate. And then there were the death threats – up to 300 by her estimate. One message on Twitter threatened to cut off her husband’s “tiny Asian penis”. The couple evacuated their house and took refuge with friends and in hotels.

Wu now devotes her time to running for Congress from her home in Dedham, Massachusetts. She sees her candidacy as a way of pressing federal authorities to take the problem of online conspiracy theories and harassment seriously. “The FBI employs about 30,000 agents in the US. As best as I can tell there’s no division that is specifically tasked with prosecuting extreme threats online – it’s simply not a priority for them,” she says.

Wu looks back on Gamergate and is torn over its legacy for her. On the positive side, “it did show me there’s a toughness and resilience inside myself, it gave me almost rhinoceros-thick skin.” Then she quickly corrects herself. “Let’s not glamorize abuse. I came to a conclusion that having to read every day about people wanting to rape or kill me did permanent damage.”

In October 2016, a month before Trump was elected, James Alefantis hosted a party to celebrate the 10th anniversary of Comet Ping Pong, his Washington DC pizza restaurant.

Within days, his establishment was under siege and he found himself at the center of the mother of all modern conspiracy theories: Pizzagate. Hillary Clinton, so the narrative went, was masterminding a global child-trafficking ring that was holding kids as sex slaves in his basement.

The rumor-mongering began when private emails of John Podesta, Clinton’s 2016 campaign manager, were stolen allegedly by Russian agents and released through WikiLeaks. In them, Podesta mentioned his brother Tony’s friend and their occasional cooking companion, Alefantis, as well as a fundraising dinner they were planning together at Comet Ping Pong.

Soon, photos of Alefantis’ godchildren were being lifted from his Instagram page and repackaged to support claims of hideous pedophilia. Conspiracy theorists were arguing that “James Alefantis” was a bastardization of “j’aime les enfant” (I like children) and that cheese pizza, “cp” for short, was a code for child pornography.

The heinous notion that Alefantis was a pedophile working with Hillary Clinton to abuse children in the basement of his restaurant (Comet Ping Pong has no basement) hurtled around the internet. Abusive messages were posted on the restaurant’s Facebook page and in Yelp reviews; one online critic claimed to have found a child’s hand in his pizza.

But it was not until bigger beasts got involved that it became truly dangerous. Trump’s pick for national security adviser, retired army general Michael Flynn, fanned the flames by tweeting about Clinton’s “sex crimes w children”. Then up popped Alex Jones once more, telling his thousands of Infowars listeners that “something’s going on, something’s being covered up”, exhorting his devotees to “go investigate it for yourself”.

So they did. The self-appointed “investigators” stepped out of the computer screen and began turning up at Comet Ping Pong.

“There was this break into the physical world that began to happen,” Alefantis recalls. “People came into the restaurant to film or look around. They came by my house, asking neighbors questions. Suddenly you look around and you don’t know who to trust.”